1 AHIP 2025 FINAL EXAM UPDATED QUESTIONS
AND VERIFIED ANSWERS, 100% GUARANTEED
PASS ||NEW UPDATE
Mrs. Shields is covered by Original Medicare. She sustained a hip
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fracture and is being successfully treated for that condition.
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However, she and her physicians feel that after her lengthy
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hospital stay, she will need a month or two of nursing and
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rehabilitative care. What should you tell them about Original
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Medicare's coverage of care in a skilled nursing facility?
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ANS✅ Medicare will cover Mrs. Shield's skilled nursing
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services provided during the first 20 days of her stay, after which
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she would have a copay until she has been in the facility for 100
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days.
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Mrs. West wears glasses and dentures and has enjoyed
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considerable pain relief from arthritis through massage therapy.
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She is concerned about whether or not Medicare will cover these
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items and services. What should you tell her?
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ANS✅ Medicare does not cover massage therapy, or, in general,
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glasses or dentures.
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Mrs. Park is an elderly retiree. Mrs. Park has a low fixed income.
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What could you tell Mrs. Park that might be of assistance?
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,2 ANS✅ She should contact her state Medicaid agency to see if she
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qualifies for one of several programs that can help with Medicare
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costs for which she is responsible.
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Mr. Alonso receives some help paying for his two generic
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prescription drugs from his employer's retiree coverage, but he
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wants to compare it to a Part D prescription drug plan. He asks you
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what costs he would generally expect to encounter when enrolling
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into a standard Medicare Part D prescription drug plan. What
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should you tell him?
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ANS✅ He generally would pay a monthly premium, annual
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deductible, and per-prescription cost-sharing.
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Mrs. Gonzalez is enrolled in Original Medicare and has a Medigap
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policy as well, but it provides no drug coverage. She would like to
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keep the coverage she has but replace her existing Medigap plan
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with one that provides drug coverage. What should you tell her?
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ANS✅ Mrs. Gonzalez cannot purchase a Medigap plan that
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covers drugs, but she could keep her Medigap policy and enroll in
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a Part D prescription drug plan.
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Mr. Davis is 52 years old and has recently been diagnosed with
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end-stage renal disease (ESRD) and will soon begin dialysis. He is
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wondering if he can obtain coverage under Medicare. What should
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you tell him?
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,3 ANS✅ He may sign-up for Medicare at any time however
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coverage usually begins on the fourth month after dialysis
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treatments start.
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Mrs. Duarte is enrolled in Original Medicare Parts A and B. She
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has recently reviewed her Medicare Summary Notice (MSN) and
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disagrees with a determination that partially denied one of her
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claims for services. What advice would you give her?
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ANS✅ Mrs. Duarte should file an appeal of this initial
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determination within 120 days of the date she received the MSN in
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the mail.
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Mrs. Geisler's neighbor told her she should look at her Part D
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options during the annual Medicare enrollment period because the
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features of Part D might have changed. Mrs. Geisler can't
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remember what Part D is so she called you to ask what her
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neighbor was talking about. What could you tell her?
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z ANS✅ Part D covers prescription drugs and she should look at
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z her premiums, formulary, and cost-sharing among other factors to
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z see if they have changed.
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Mr. Rainey is experiencing paranoid delusions and his physician
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feels that he should be hospitalized. What should you tell Mr.
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Rainey (or his representative) about the length of an inpatient
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psychiatric hospital stay that Medicare will cover?
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, 4 ANS✅ Medicare will cover a total of 190 days of inpatient
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psychiatric care during Mr. Rainey's entire lifetime.
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Mr. Xi will soon turn age 65 and has come to you for advice as to
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what services are provided under Original Medicare. What should
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you tell Mr. Xi that best describes the health coverage provided to
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Medicare beneficiaries?
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ANS✅ Beneficiaries under Original Medicare have no cost-
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sharing for most preventive services. z z z z
Mr. Singh would like drug coverage but does not want to be
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enrolled in a Medicare Advantage plan. What should you tell him?
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zzzz
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ANS✅ Mr. Singh can enroll in a stand-alone prescription drug
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plan and continue to be covered for Part A and Part B services
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through Original Fee-for-Service Medicare.
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Mrs. Chen will be 65 soon, has been a citizen for twelve years, has
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been employed full time, and paid taxes during that entire period.
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She is concerned that she will not qualify for coverage under part
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A because she was not born in the United States. What should you
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tell her?
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ANS✅ Most individuals who are citizens and age 65 or over are
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covered under Part A by virtue of having paid Medicare taxes
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while working, though some may be covered as a result of paying
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monthly premiums.
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